Introduction

The chances of HIV being passed from one person to another depend on the
type of contact. HIV is most easily spread, or transmitted, through unprotected
anal sex, unprotected vaginal sex, and sharing injection drug equipment.
Unprotected sex means sex in which no condoms or other barriers are used.

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Oral sex has been shown to be less risky than these activities, but it is
not risk-free. Oral sex involves contact between the mouth and the genitals. It
includes giving or receiving licking, sucking, or biting of the vulva (vagina,
clitoris, and labia, or "lips), penis, or anus.

HIV is present in female sexual fluid (vaginal secretions), male
sexual fluids ("cum and "pre-cum), and blood. HIV cannot be spread through saliva (spit). It is also possible to get other sexually-transmitted diseases (STDs), such as syphilis, herpes, gonorrhea and human papilloma virus (HPV) through oral sex.

Studies on the Risks of Oral Sex

Even though oral sex is a lower-risk activity for HIV, several reports show that
people have become infected with HIV through oral sexual activity. A number of
studies have tried to figure out the exact level of risk of oral sex, but it
can be difficult to get accurate information. When HIV is spread, it is
difficult to tell if it was the oral sex or another, more risky sexual activity
that was responsible for spreading HIV since oral sex is not the only sexual
activity for most people. Other factors also increase the risk of oral sex,
including bad oral hygiene, genital sores, and the presence of other STDs.

The take home message is that oral sex carries a small but real risk.

Tips for Safer Oral Sex

Oral sex is more risky if you or your partner has an untreated STD or bad oral hygiene (bleeding gums, ulcers, gum disease), or take ejaculate (cum) in the
mouth. There are things you can do to reduce the risk associated with oral
sex:

Do not have oral sex if you or your partner has mouth sores (such as oral
herpes lesions)

Look at your partner's genitals for lesions (cuts, scrapes, or sores)

If you find something, avoid contact with the area until a health care
provider examines it. Very rarely are genital lesions the result of the heat,
the weather, or someone's clothes.

Do not floss, brush your teeth, or do anything that would create cuts or
cause bleeding in your mouth before performing oral sex. Use mouthwash or a
breath mint instead.

Avoid swallowing pre-cum, semen, or vaginal fluids

Use latex condoms for oral sex on a man (try the flavored
ones that come without lube on them)

If you perform oral sex without a condom, finish up with your hand, or spit
semen out and rinse with a mouthwash rather than swallowing it

Use a dental dam or cut-open condom for oral sex on a woman or for rimming
(licking the anus)

Dental dams are squares made from latex. Put some water-based lube on one
side of the dental dam or a condom that has been cut open. Then stretch the dam
or condom over the vagina or anus with the lubed side facing down. This gives
you a thin barrier between your mouth and the vagina or anus. (Some people use
plastic food wrap as a barrier. While plastic wrap has been shown to prevent
the transmission of herpes infections, there has been no research on its
effectiveness in preventing HIV transmission.)

Avoid vaginal oral sex when a woman is menstruating (having her period or cycle) to prevent contact with
blood

Take care of your mouth. The chances of getting HIV from oral sex increase
if you have bleeding gums, ulcers, cuts, sores, or infections in the
mouth.

Use alternatives.

Try massage or mutual masturbation

Try a vibrator (use a condom when sharing)

Avoid giving a man oral sex if his penis is bruising your throat or tonsils
(sometimes caused by "deep-throating"), or if you experience injuries
around your mouth

Taking Care of Yourself

While the risk of becoming infected through unprotected oral sex is lower
than that of unprotected anal or vaginal sex, it is not risk-free. If you or
your partner is living with HIV (HIV+), you should decide what steps to take to
make all types of sex safer (see our safer
sex info sheet). Remember that bad oral hygiene and taking cum or menstrual blood in your
mouth can make oral sex more risky. If you would like to discuss these issues,
see a sex educator or health care provider at your local AIDS service
organization or treatment center.

This article was provided by The Well Project.
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